| NPI | 1982483384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA CP044795T) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT41454) |
| 225100000X Physical Therapist (Licence: VA 2305216544) | |
| 225100000X Physical Therapist (Licence: TN 16143) | |
| 225100000X Physical Therapist (Licence: AZ LPT-33245) | |
| 225100000X Physical Therapist | |
| Enumeration Date | 2023-09-25 |
| Last Update Date | 2025-06-04 |